人类胆固醇酯转移蛋白rs5882基因多态性与围术期神经认知功能紊乱的相关性

Relationship between human cholesteryl ester transfer protein rs5882 gene polymorphism and postoperative cognitive dysfunction

目的:探讨人类胆固醇酯转移蛋白(CETP)rs5882多态性和围术期神经认知功能紊乱(PND)的相关性。方法:选择65岁及以上行择期非心脏手术患者124例(观察组)及年龄、性别匹配的健康志愿者25例作为对照组。于术前1天、术后7 d、术后3月或对应时间分别行神经心理学测试,通过采用“Z值法”诊断PND。术前采集手术患者静脉血样,使用单核苷酸多态性(SNP)检测技术,分析rs5882多态性与PND的相关性。结果:术后7 d和3月PND发病率分别为29.3%和18.2%。术后7 d、3月时,PND组A等位基因出现的频率均显著高于非PND组,而G等位基因均低于非PND组(7 d 65.52%vs.41.43%,34.48%vs.58.57%,P=0.001;3月58.33%vs.37.86%,41.67%vs.62.14%,P=0.004)。AA基因型在PND组出现的频率在术后7 d及术后3月分别为34.48%和38.89%,均显著高于非PND组的14.29%和16.05%(P=0.023,P=0.029)。结论:CETP rs5882基因多态性与术后PND密切相关,AA基因型可能是中国汉族老年患者术后PND发病的易感因子。

AIM:To investigate the relationship between human cholesteryl ester transfer protein CETP gene polymorphism and postoperative neurocognitive disorders(PND).METHODS:A total of 124 elderly patients over 65 years of age who underwent elective non-cardiac surgery were enrolled in the study while 25 healthy volunteers matching age and sex were recruited as the control group.Neuropsychological tests were performed 1 day before surgery,7 days,and 3 months after surgery.PND was determined using the Z value method.The venous blood sample of the surgical patient was taken before the operation,followed by direct gene sequencing.Statistical methods were used to calculate the correlation between CETP gene polymorphism(rs5882)and PND.RESULTS:The incidence of PND was 29.3%and 18.2%at 7 days and 3 months after operation respectively.The A allele frequency of PND patients was significantly higher than that of non-PND patients 7 days and 3 months after surgery(65.52%vs.41.43%,34.48%vs.58.57%,P=0.001),while the G allele frequency in PND group lower than that of non-PND(58.33%vs.37.86%,41.67%vs.62.14%,P=0.004).AA genotype in PND patients was 34.48%,38.89%at 7 days and 3 months after surgery respectively,significantly higher than 14.29%,16.05%of non-PND(P=0.023,P=0.029).CONCLUSION:CETP rs5882 polymorphism is associated with PND and AA genotype may be a predisposing factor for postoperative PND in Chinese Han elderly patient.